Monday, November 14, 2016

Grit in Psychological Health and Illness

I've recently finished reading a book called Grit, by Angela Duckworth.  The author is a research psychologist who is part of the faculty at Harvard University.  She also has a background and interest in childhood education, which is very relevant to her other work.

It is a good overview of the research that has been done about the factors that lead to success and achievement in various domains of life, such as in a profession, in athletics, and in the performing arts.

The author's thesis, in a nutshell, is that "grit", which she defines as perseverance over a long period of time, the practice of being undeterred by failures or disappointments, and the maintenance of long-term purposeful goals, is a much stronger factor leading to success, compared to hereditary factors or "talent."

While this may seem like an obvious truth, it is important to realize that the educational system, and the culture as a whole, tends to value the idea of "talent" more strongly than the idea of "persistent hard work."   In one interesting study, an identical performance was judged more highly if the observers were told that the performer was "talented" compared to being told that the performer had "worked really hard."

How is this relevant to mental health?

Here are some of Duckworth's ideas, applied to mental health management:

1) if you are working on mental health, consider that it is necessary to work on this for years.  Duckworth's research shows that successful endeavours in almost all spheres of life require a commitment of at least 2 years' time.  During this time, it is necessary to have diligent, daily practice.  This is not unlike the routines needed by a musician or athlete.  This work needs to be guided by a long-term meaningful vision.  The work may at times be difficult or even painful, and the work may be interrupted by periodic failures.  The disappointing times must be accepted without allowing them to interrupt the work.  In fact, it is necessary to learn from the disappointments rather than be derailed by them.

2) Duckworth ponders the unresolved question of whether the daily disciplined work needed for success must be "enjoyable."  A lot of the work, in athletes for example, shows that the workouts needed for excellence are not, or cannot be, truly "enjoyable."  The required work must challenge the status quo of your body's physiology and reflexes, and this is never easy to do.   In this sense, a recipe for excellence is a tolerance for discomfort, which could be nurtured through practice.  But I think this view could be reframed:  the hard work needed may in the moment be uncomfortable, but provided there is an overarching sense of meaning and joy which guides the process, the periods of intense work would then fit into a paradigm of balanced health.    I also believe that a good therapist, teacher, or coach, should always strive to make hard work as enjoyable as possible.  Therapy itself may sometimes be quite joyful, and need not always be emotionally taxing.

3) In order to facilitate the years of work and discipline needed for growth and change, it is usually necessary to be part of a culture or community of change.  Athletes are usually part of a team, whose members motivate each other.  Musicians and academics hopefully are part of communities whose actions challenge and maintain growth and practice.   It can make a huge difference to have a dedicated teacher or coach who believes in you, who sees your potential, and who challenges you to work hard.   In mental health, I think a good therapist can have a "coach-like" or "teacher-like" role in this way.  I think a good therapist should strive to be inspiring, motivating, but also challenging.

4) As Duckworth shows, it is necessary to have a sense of purpose in order to be able to commit to years of hard work.  In depression, it is often the case that a sense of purpose is weakened or lost.  It is of the utmost importance in therapy to address the issue of meaning.  Without meaning, the hard work required for change could feel like a terribly draining, pointless chore.   But how can we recapture meaning which has been lost?  Maybe sometimes it is not so easy, but we can start by at least addressing it in conversation, and exploring possibilities.  Often, in depression, meaning can be rekindled through behavioural exploration, in conjunction with relief of symptoms.   In other cases, meaning can be recaptured even when other symptoms are at their worst.

5) One of the connotations of this type of work is that short-term models of mental health care are unlikely to lead to mental health "excellence," unless they serve merely as preliminary introductions to new ways of being.    Just like in a successful classroom, sports team, or company, the atmosphere of change must allow for a sustained, long-term commitment.    But it is an important critique of some longer-term therapy, that it can become too passive, just like the situation in which a teacher or coach becomes resigned to a class or a team which is not thriving.  A good therapist, just like a good teacher or coach, must always strive for growth and change, while also helping the process to be as joyful and meaningful as possible.

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